As medical and hospital costs continue to increase, surgeons are constantly striving to develop advanced surgical techniques. Advances in the surgical field are often related to the development of operative techniques which involve less invasive surgical procedures and reduce overall patient trauma. In this manner, the length of hospital stays can be significantly reduced, and therefore the hospital and medical costs can be reduced as well.
One of the truly great advances in recent years to reduce the invasiveness of surgical procedures is endoscopic surgery. Endoscopic surgery involves the use of an endoscope, which is an instrument permitting the visual inspection and magnification of any cavity of the body. The endoscope is inserted through a cannula after puncture through the wall of the body cavity with a trocar, which is a sharp-pointed instrument. The surgeon can then perform diagnostic and therapeutic procedures at the surgical site with the aid of specialized instrumentation designed to fit through additional cannulas providing openings into the desired body cavity as may be required.
In many surgical procedures, including those involved in endoscopic surgery, it is often necessary to remove bodily tissue or damaged bodily organs. This is especially challenging during endoscopic surgery because of the small openings through which such tissue or organs must be removed. Under these circumstances, it is necessary to fragment, or morcellate, the bodily tissue so that it can be readily removed through the small endoscopic openings.
In response to the need to morcellate and remove bodily tissue during endoscopic surgery, devices have been developed to aid the surgeon. For example, Ison et al., Journal of Medical Engineering and Technology, Vol. 13, No. 6 (Nov./Dec. 1989), pages 285-289, discloses an endoscopic or laparoscopic instrument for removing tissue, referred to in the art as a tissue morcellator, through a small cross-section. An article in General Surgery News, 11 (10) 1990 illustrates the feasibility of laparoscopic nephrectomy which is an endoscopic procedure for excising a kidney, by first enclosing the desired kidney in a nylon drawstring entrapment sack and then using a tissue morcellator to fragment and aspirate the kidney from the sack.
In other endoscopic surgical procedures, it is often necessary or desired to enclose a fractured organ during surgical repair to aid the surgeon in maintaining the integrity of the bodily organ. A device for accomplishing this task is disclosed in U.S. Pat. No. 4,428,375. This patent describes a drawstring mesh or net bag for encapsulating a fractured organ during surgical repair. The bag is intended to conform to the organ shape and compress the organ sufficiently to close any organ fractures and provide hemostasis. Similar type devices for enclosing fractured or damaged organs are described in U.S. Pat. Nos. 4,878,890; 2,143,910 and 3,983,863. Unfortunately, none of the devices described in these patents are particularly suitable for endoscopic surgery.
In view of the advances made to date in the field of endoscopic surgery, it would be desirable to fabricate an endoscopic instrument which can perform a variety of functions to enable the surgeon to carry out surgical procedures endoscopically. More specifically, it would be desirable to fabricate an endoscopic device capable of morcellating bodily tissue or organs and to remove such tissue or organs, and to facilitate the surgical repair of fractured organs with an endoscopic device capable of enclosing such fractured organs.